Organization
FIDELITY SURGICAL SUITES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT M HOWINGTON CRNA (PRESIDENT)
(972) 743-2126
Entity
Organization
Contact information
Practice address
2452 LAKEWOOD DR, GRAND PRAIRIE, TX 75054-6800
(972) 743-2126
Mailing address
2452 LAKEWOOD DR, GRAND PRAIRIE, TX 75054-6800
(972) 743-2126
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
70862
TX
Other
Enumeration date
02/26/2016
Last updated
02/26/2016
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